Arnold P G, Pairolero P C
Section of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minn.
Plast Reconstr Surg. 1989 Jul;84(1):92-8; discussion 99.
From 1977 to 1987, 87 consecutive patients underwent intrathoracic muscle transposition. Indications for the operation were bronchopleural fistula, postpneumonectomy empyema, perforation of the heart or great vessels, esophageal fistula, tracheal fistula, empyema, and prophylactic reinforcements of the airway. Of the 118 muscles transposed, the serratus anterior was used in 48 patients, the latissimus dorsi in 33, the pectoralis major in 26, and other muscles in 11. Depending on the wound status at the time of muscle transposition, the chest either was left open for dressing changes or was closed primarily. The number of operations per patient ranged from 1 to 16 (median 2). There were 13 operative deaths (14.9 percent). The follow-up period ranged from 3.9 to 130.9 months (median 28.3 months). Overall results were excellent in 65 patients (74.7 percent). There was no difference in results when considered according to treatment indication. We conclude that when there is an actual or potential leak of the tracheobronchial tree, heart and great vessels, or intrathoracic gastrointestinal tract, intrathoracic muscle transposition can be a lifesaving adjunct.
1977年至1987年，连续87例患者接受了胸内肌肉移位术。手术适应证包括支气管胸膜瘘、肺切除术后脓胸、心脏或大血管穿孔、食管瘘、气管瘘、脓胸以及气道的预防性加固。在移位的118块肌肉中，48例患者使用了前锯肌，33例使用了背阔肌，26例使用了胸大肌，11例使用了其他肌肉。根据肌肉移位时的伤口情况，胸部要么敞开进行换药，要么一期缝合。每位患者的手术次数为1至16次（中位数为2次）。有13例手术死亡（14.9%）。随访时间为3.9至130.9个月（中位数为28.3个月）。65例患者（74.7%）的总体结果良好。根据治疗适应证分析，结果无差异。我们得出结论，当气管支气管树、心脏和大血管或胸内胃肠道存在实际或潜在的渗漏时，胸内肌肉移位术可以作为一种挽救生命的辅助手段。
